December 28, 2013
Dreonna Breton was very concerned about her fourth pregnancy.
Now she and her husband, Jeremy, are worried about paying their bills after she was fired from her job as a registered nurse on Dec. 17.
"It's a scary place to be," she said. "We depend on my income heavily."
Breton, 29, lost her job for refusing to be immunized against the flu.
And the Bretons, who live in West Donegal Township with their 19-month-old son, Westen, do not regret her decision.
"We know we did the right thing," she said Thursday.
After going through two miscarriages, she didn't want to take any chances.
"It was very emotional," she said of her miscarriages in March and June. "It's not something I've gotten over. I mean, we put ornaments on our tree for the babies."
When she learned in October that she was pregnant, she got busy researching the safety of flu vaccines for pregnant women.
She knew her employer, Horizon Healthcare Services in Manheim Township, was requiring all personnel to get a flu shot.
Employer's stand, reasons
Asked about the flu shot requirement, part-owner Lancaster General Health sent a statement on behalf of Horizon's president, Carolyn Carlson, a registered nurse.
"Like our requirements for TB skin testing and MMR (measles, mumps and rubella) vaccination as a condition of employment, mandatory flu immunization protects our patients, employees, and community from getting this potentially serious infection," Carlson says in the statement, which cites Lancaster General Health's similar policy.
Horizon Healthcare Services is owned equally by four partners: Lancaster General Health, Reading Health System, PinnacleHealth System and Penn State Hershey. LGH handles payroll, human resources and employee health services for Horizon, according to LGH spokesman John Lines.
Lines said Horizon requires any employee exempt for medical or religious reason from the flu vaccination requirement to wear a mask the entire shift.
Why not a mask?
Breton disagrees.
She was willing to wear a mask throughout flu season.
And, if patient safety is the issue, that should be good enough, she said, given that employees can get exemptions for medical reasons such as allergies and if their religious convictions forbid immunizations.
Dr. Alan Peterson, director of community and environmental medicine at Lancaster General Health, said it is in the best interests of patients and employees for health-care workers to get vaccinated against the flu.
"It is both an ethical and a moral issue," he said. "The fact that a health care worker could potentially be spreading an organism, to healthy people or to unhealthy people is just not conscionable."
And, he said, pregnant women are at greater risk of getting the flu, and anyone who gets the flu is at risk of illness or death.
On masks, he said, they are not 100 percent effective, with germs being able to escape from their tops, bottoms or sides. He acknowledged that masks do provide some protection and are permitted on a case-by-case basis for LGH employees exempted from the flu-shot requirement.
Dr. Kurt Barnhart, chairman of the Pennsylvania section of the American College of Obstetricians and Gynecologists, and an OB-GYN at the University of Pennsylvania's Perelman School of Medicine, said his organization recommends that pregnant women get a flu vaccine, as long as it does not contain a live virus. Vaccinations containing a live virus are rare these days, he said.
The Centers for Disease Control and Prevention agrees with Barnhart and his organization.
"Flu is more likely to cause severe illness in pregnant women than in women who are not pregnant," according to the CDC's website.
"Changes in the immune system, heart and lungs during pregnancy make pregnant women more prone to severe illness from flu, which can lead to hospitalization or even death.
"A pregnant woman with the flu also has a greater chance of serious problems for her unborn baby, including premature labor and delivery."
While certain that all women, including pregnant women, are better off with a flu vaccine, Barnhart was not as sure regarding the protection a mask might provide.
"I don't think we know," he said, "but I suspect a mask is not as good as a vaccine. That's why we recommend the vaccine."
A nurse's concerns
Breton, who lives about 3 miles west of Elizabethtown Public Library, said she has read the website.
"The CDC has looked at it," she said. "I understand that, but it's not 100 percent safe."
She said she remembered a patient she was working with because of bedsores in 2008, her first year as a nurse. He had been paralyzed as a result of Guillain-Barré Syndrome, or GBS, after getting a flu vaccine.
So, Breton, who worked for Horizon as an infusion nurse since February 2011, got busy.
She researched a key question: Is the flu vaccine safe for pregnant women and their babies?
Not safe enough, as far as Breton was concerned.
The packaging for flu vaccines for the 2013-14 season threw up red flags.
The labels for flu vaccines available in Pennsylvania from GlaxoSmithKline, Novartis and Sanofi Pasteur:
•Acknowledge not having been tested in pregnant women.
•Acknowledge that animal tests either have not been done or their results are not transferable to humans.
•Suggest administering them to women who are pregnant or nursing only if clearly needed or in consultation with a physician.
Trying to keep her job
With such concerns in mind, Breton went to human resources.
Not long after, she received an email telling her that if she did not get a flu shot, she would be considered to have resigned as of Nov. 15.
On Nov. 14, she got another email saying she needed a doctor's note indicating a medical reason for her not doing so.
First, she went to her midwife, a certified nurse, who wrote a letter citing the fact that Pennsylvania law does not require nurses to get them, the lack of tests on pregnant women regarding vaccines and a citation by the Food and Drug Administration that flu vaccines are not demonstrated safe for pregnant women.
That wasn't good enough, Breton said. The note had to be from a doctor.
So, she went to her doctor, an LGH doctor, and he said he would give her a letter, but not a medical reason.
"In my view," the doctor wrote, "getting the flu shot would significantly and negatively impact her health because of the increased fear and anxiety it would create as well as the emotional impact it could cause if she does miscarry again."
The second letter didn't save her job either because it did not cite a medical reason, Breton said.
She then was told, in an email Dec. 5, that she would be suspended as of Dec. 10 and terminated on Dec. 17 if she did not get a flu vaccination.
When working with her employer didn't work, the couple began looking for another solution.
"We prayed about it," Jeremy Breton said.
Dreonna Breton said she was not interested in seeking news coverage, but at a certain point, it seemed like the only option.
"We felt like we were not being heard," she said. "It's just so frustrating.
"It's ironic. I have the right to terminate the pregnancy, but I don't have the right not to put a pharmaceutical in my body that has not been tested on a fetus or on a pregnant woman?"
Breton, who worked nights, said she was good at what she did, helping hook up adult patients of all ages to intravenous tubes for antibiotics, hydration and chemotherapy.
"I loved my job," she said. "I was hoping to keep it for quite a long time."
She is looking to get back to work but understands the difficulty of finding a job when she likely will be going out on maternity leave soon. She is due June 30.
Are they ready to sue?
She'd like to, and only to get the policy changed, Breton said, but the risk of losing the case and going into debt is too great.
They're struggling financially as it is.
Her husband is hopeful.
"Everything will work out," he said. "What's meant to be is meant to be. We're guided by God's lantern."
source
Now she and her husband, Jeremy, are worried about paying their bills after she was fired from her job as a registered nurse on Dec. 17.
"It's a scary place to be," she said. "We depend on my income heavily."
Breton, 29, lost her job for refusing to be immunized against the flu.
And the Bretons, who live in West Donegal Township with their 19-month-old son, Westen, do not regret her decision.
"We know we did the right thing," she said Thursday.
After going through two miscarriages, she didn't want to take any chances.
"It was very emotional," she said of her miscarriages in March and June. "It's not something I've gotten over. I mean, we put ornaments on our tree for the babies."
When she learned in October that she was pregnant, she got busy researching the safety of flu vaccines for pregnant women.
She knew her employer, Horizon Healthcare Services in Manheim Township, was requiring all personnel to get a flu shot.
Employer's stand, reasons
Asked about the flu shot requirement, part-owner Lancaster General Health sent a statement on behalf of Horizon's president, Carolyn Carlson, a registered nurse.
"Like our requirements for TB skin testing and MMR (measles, mumps and rubella) vaccination as a condition of employment, mandatory flu immunization protects our patients, employees, and community from getting this potentially serious infection," Carlson says in the statement, which cites Lancaster General Health's similar policy.
Horizon Healthcare Services is owned equally by four partners: Lancaster General Health, Reading Health System, PinnacleHealth System and Penn State Hershey. LGH handles payroll, human resources and employee health services for Horizon, according to LGH spokesman John Lines.
Lines said Horizon requires any employee exempt for medical or religious reason from the flu vaccination requirement to wear a mask the entire shift.
Why not a mask?
Breton disagrees.
She was willing to wear a mask throughout flu season.
And, if patient safety is the issue, that should be good enough, she said, given that employees can get exemptions for medical reasons such as allergies and if their religious convictions forbid immunizations.
Dr. Alan Peterson, director of community and environmental medicine at Lancaster General Health, said it is in the best interests of patients and employees for health-care workers to get vaccinated against the flu.
"It is both an ethical and a moral issue," he said. "The fact that a health care worker could potentially be spreading an organism, to healthy people or to unhealthy people is just not conscionable."
And, he said, pregnant women are at greater risk of getting the flu, and anyone who gets the flu is at risk of illness or death.
On masks, he said, they are not 100 percent effective, with germs being able to escape from their tops, bottoms or sides. He acknowledged that masks do provide some protection and are permitted on a case-by-case basis for LGH employees exempted from the flu-shot requirement.
Dr. Kurt Barnhart, chairman of the Pennsylvania section of the American College of Obstetricians and Gynecologists, and an OB-GYN at the University of Pennsylvania's Perelman School of Medicine, said his organization recommends that pregnant women get a flu vaccine, as long as it does not contain a live virus. Vaccinations containing a live virus are rare these days, he said.
The Centers for Disease Control and Prevention agrees with Barnhart and his organization.
"Flu is more likely to cause severe illness in pregnant women than in women who are not pregnant," according to the CDC's website.
"Changes in the immune system, heart and lungs during pregnancy make pregnant women more prone to severe illness from flu, which can lead to hospitalization or even death.
"A pregnant woman with the flu also has a greater chance of serious problems for her unborn baby, including premature labor and delivery."
While certain that all women, including pregnant women, are better off with a flu vaccine, Barnhart was not as sure regarding the protection a mask might provide.
"I don't think we know," he said, "but I suspect a mask is not as good as a vaccine. That's why we recommend the vaccine."
A nurse's concerns
Breton, who lives about 3 miles west of Elizabethtown Public Library, said she has read the website.
"The CDC has looked at it," she said. "I understand that, but it's not 100 percent safe."
She said she remembered a patient she was working with because of bedsores in 2008, her first year as a nurse. He had been paralyzed as a result of Guillain-Barré Syndrome, or GBS, after getting a flu vaccine.
So, Breton, who worked for Horizon as an infusion nurse since February 2011, got busy.
She researched a key question: Is the flu vaccine safe for pregnant women and their babies?
Not safe enough, as far as Breton was concerned.
The packaging for flu vaccines for the 2013-14 season threw up red flags.
The labels for flu vaccines available in Pennsylvania from GlaxoSmithKline, Novartis and Sanofi Pasteur:
•Acknowledge not having been tested in pregnant women.
•Acknowledge that animal tests either have not been done or their results are not transferable to humans.
•Suggest administering them to women who are pregnant or nursing only if clearly needed or in consultation with a physician.
Trying to keep her job
With such concerns in mind, Breton went to human resources.
Not long after, she received an email telling her that if she did not get a flu shot, she would be considered to have resigned as of Nov. 15.
On Nov. 14, she got another email saying she needed a doctor's note indicating a medical reason for her not doing so.
First, she went to her midwife, a certified nurse, who wrote a letter citing the fact that Pennsylvania law does not require nurses to get them, the lack of tests on pregnant women regarding vaccines and a citation by the Food and Drug Administration that flu vaccines are not demonstrated safe for pregnant women.
That wasn't good enough, Breton said. The note had to be from a doctor.
So, she went to her doctor, an LGH doctor, and he said he would give her a letter, but not a medical reason.
"In my view," the doctor wrote, "getting the flu shot would significantly and negatively impact her health because of the increased fear and anxiety it would create as well as the emotional impact it could cause if she does miscarry again."
The second letter didn't save her job either because it did not cite a medical reason, Breton said.
She then was told, in an email Dec. 5, that she would be suspended as of Dec. 10 and terminated on Dec. 17 if she did not get a flu vaccination.
When working with her employer didn't work, the couple began looking for another solution.
"We prayed about it," Jeremy Breton said.
Dreonna Breton said she was not interested in seeking news coverage, but at a certain point, it seemed like the only option.
"We felt like we were not being heard," she said. "It's just so frustrating.
"It's ironic. I have the right to terminate the pregnancy, but I don't have the right not to put a pharmaceutical in my body that has not been tested on a fetus or on a pregnant woman?"
Breton, who worked nights, said she was good at what she did, helping hook up adult patients of all ages to intravenous tubes for antibiotics, hydration and chemotherapy.
"I loved my job," she said. "I was hoping to keep it for quite a long time."
She is looking to get back to work but understands the difficulty of finding a job when she likely will be going out on maternity leave soon. She is due June 30.
Are they ready to sue?
She'd like to, and only to get the policy changed, Breton said, but the risk of losing the case and going into debt is too great.
They're struggling financially as it is.
Her husband is hopeful.
"Everything will work out," he said. "What's meant to be is meant to be. We're guided by God's lantern."
source
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